{"id":120186,"date":"2023-09-22T10:33:29","date_gmt":"2023-09-22T10:33:29","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=120186"},"modified":"2023-09-22T10:33:30","modified_gmt":"2023-09-22T10:33:30","slug":"cpc-exams-solution-guides-2023-complete-verified-questions-and-answers-helping-you-to-ace-your-cpc-certification-exam-in-one-attempt","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2023\/09\/22\/cpc-exams-solution-guides-2023-complete-verified-questions-and-answers-helping-you-to-ace-your-cpc-certification-exam-in-one-attempt\/","title":{"rendered":"CPC Exams Solution Guides 2023: Complete Verified Questions and Answers helping you to Ace Your CPC Certification Exam in One Attempt"},"content":{"rendered":"\n

CPC Exam – 150 Questions and Answers Complete 2022 solution guide. (answered) CPC Exam Study Guidelines to Ace Your CPC Certification Exam. CPC Exam Study Guide 2021\/2022: Questions and Answers. AAPC CPC Testbank Exam Prep 2022 Complete Questions & Answers. (answered) AAPC CPC exam Compliance and Regulatory 2022.<\/p>\n\n\n\n

CPC Practice Exam – 150 Questions
Surgical removal – The suffix -ectomy means
Magnetic Resonance Imaging – MRI stands for
The removal of the fallopian tubes and ovaries – The term “Salpingo-Oophorectomy” refers to
Freezing – Cryopreservation is a means of preserving something through
Paracentesis – Which of the following describes the removal of fluid from a body cavity
Gastrotomy – If a surgeon cuts into a patient’s stomach he has performed a
Muscle – In the medical term myopathy the term pathy means disease. What is diseased?
Measles, Mumps, Rubella, and Varicella – The acronym MMRV stands for
Outer bone located in the forearm – The Radius is the
Hemic and Lymphatic – The spleen belongs to what organ system?
The distal portion – The portion of the femur bone that helps makes up the knee cap is considered
what?
Middle – The Midsagittal plane refers to what portion of the body?
Cecum – Which of the following is not part of the small intestine?
Teres – One of the six major scapulohumeral muscles
Where to esophagus joins the stomach – The cardia fundus is
Amputation, arm through humerus; secondary closure or scar revision – The full description of
CPT code 24925 is:
The condition of the patient justifies the service provided – Medical necessity means what?
45392 – Which of the following codes allows the use of modifier 51?
It helps cover outpatient charges – Which of the following statements is not true regarding
Medicare Part A
External cause codes are only used in the initial encounter. – Which of the following statements
is false?<\/p>\n\n\n\n

Exploration, including enlargement, debridement, removal of foreign body(ies), minor vessel
ligation, and repair – Wound exploration codes include the following service (s) :
I12.9, N18.3 – What is the correct ICD-10-CM code(s) for malignant hypertension with stage III
kidney disease?
S51.822A, W07.XXXA, W25.XXXA, Y93.E9, Y92.030 – Lucy was standing on a chair in her
apartment’s kitchen trying to change a light bulb when she slipped and fell. She struck the glass
top stove, which shattered. She presents to the ER with a simple laceration to her left forearm
that has embedded glass particles. Which is the correct code(s)?
T20.30XA, T24.319A, T22.299A, T31.42, X03.0XXA – Jim was at a bonfire when he tripped
and fell into the flames and sustained multiple burns. He came to the emergency room via an
ambulance and was treated for second and third degree burns on his face, second degree burns on
his upper arms and forearms, and third degree burns on the fronts of his thighs Which is the
correct code(s)?
O63.0, O09.513, Z37.0 – . A 35 year old woman who is pregnant in her 38th week with her first
child is admitted to the hospital. She experiences a prolonged labor during the first stage and
eventually births a healthy baby boy. Which is the correct code(s)?
S62.632A, Y93.64, W51.XXXA, Y92.320 – Henry was playing baseball at the town’s sports field
and slid for home base where he collided with another player. He presents to the emergency
department complaining of pain in the distal portion of his right middle finger. It is swollen and
deformed. The physician orders an x-ray and diagnoses Henry with a displaced tuft fracture. He
splints the finger, provides narcotics for pain, and instructs Henry to follow-up with his
orthopedist in two weeks. Which is the correct code(s)?
F15.20, F10.20, F41.1, F43.10 – A 60 year old male is admitted for detoxification and
rehabilitation. He has continuously abused amphetamines to the point that he cannot voluntarily
stop on his own and has become dependent upon them. He also has a long documented history of
alcohol abuse and alcoholism. He experiences high levels of anxiety due to PTSD, which causes
him to use and abuse substances. Which is the correct code(s)?
E11.319 – A patient with uncontrolled type II diabetes is experiencing blurred vision and an
increase in floaters appearing in her vision. She is diagnosed with diabetic retinopathy. Which is
the correct code(s)?
Z21 – A patient who is known to be HIV positive but who has no documented symptoms would
be assigned code
L55.1 – A patient fell asleep on the beach and comes in with blistering on her back. She is
diagnosed with second degree solar radiation burns. Which is the correct code(s)?<\/p>\n\n\n\n

True – Signs and symptoms that are associated routinely with a disease process should not be
assigned as additional codes, unless otherwise instructed by classification.
A6252, A6219 – A patient has a home health aide come to his home to clean and dress a burn on
his lower leg. The aide uses a special absorptive, sterile dressing to cover a 20 sq. cm. area. She
also covers a 15sq. cm. area with a self-adhesive sterile gauze pad.
Q4010 – A 12 year old arrives in his pediatrician’s office after colliding with another player
during a soccer game. He is complaining of pain in his right wrist. The physician orders an x-ray
and diagnoses him with a hairline fracture of the distal radius. He has a short arm fiberglass cast
applied and discharges him with follow up instructions.
J9070 – A patient with Hodgkin’s disease takes Neosar as part of his chemotherapy regiment. He
receives 100 mg once a week through intravenous infusion. Which is the correct code(s)?
A5500-A5513 – A patient with diabetes is fitted for custom molded shoes. What is the code
range for such a fitting? Which is the correct code(s)?
E1222 – A 300lb. paraplegic needs a special sized wheelchair with fixed arm rests and elevating
leg rests. Which is the correct code(s)?
99211 – A patient comes into her doctor’s office for her weekly blood sugar check. Her blood is
drawn by the LPN on staff, the visit takes about 5 minutes total. Which is the correct code(s)?
99234 – A three year old child is brought into the ER after swallowing a penny. A detailed
history and exam are taken on the child and medical decision making is of moderate complexity.
The child is admitted to observation for three hours and is then discharged home. Which is the
correct code(s)?
99471; J80; J18.9 – A 20 month old child is admitted to the hospital with pneumonia and acute
respiratory distress. The physician spends 3 minutes intubating the child and spends 90 minutes
of Critical Care time stabilizing the patient. Which is the correct code(s)?
99360;99465; 99460 – At the request of a physician who is delivering for a high risk pregnancy,
Dr. Smith, a pediatrician, is present in the delivery room to assist the infant if needed. After
thirty minutes the infant is born, but is not breathing. The delivering physician hands the infant to
Dr. Smith who provides chest compressions and resuscitates the infant. The pediatrician then
performs the initial evaluation and management and admits the healthy newborn to the nursery.
What codes should Dr. Smith submit on a claim?
99397, 99215 – Mr. Johnson is a 79 year old established male patient that is seen by Dr.
Anderson for his annual physical exam. During the examination Dr. Anderson notices a
suspicious mole on Mr. Johnson’s back. The Doctor completes the annual exam and documents a
detailed history and exam and the time discussing the patient’s need to quit smoking. Dr.
Anderson then turns his attention to the mole and does a complete work up. He documents a
comprehensive history and examination and medical decision making of moderate complexity.<\/p>\n\n\n\n

CPC Exam Questions & Answers
When a patient has a blood test for HIV that is inconclusive, what ICD-10-CM code is
assigned
a. Z21
b. R75
c. B20
d. Z11.4 – b. R75
What does MRSA stand for
a. Methicillin Resistant Staphylococcus Aureus
b. Methicillin Resistant Streptococcus Aureus
c. Moderate Resistance Susceptible Aureus
d. Mild Resistance Steptococcus Aureus – a. Methicillin Resistant Staphylococcus
Aureus
What does the forth character in diabetes mellitus diabetes codes indicate?
a. The condition as controlled or uncontrolled
b. Any complication associated with diabetes
c. Type of diabetes (type 1, or Type 2, secondary)
d. If the diabetes is primary or secondary diabetes – b. Any complication associated with
diabetes
When do you code acute respiratory failure as a secondary diagnosis
a. the patient has any other condition at the same time
b. When it is determined to be the cause of the shortness of breath
c. Acute respiratory failure is always listed first
d. When it occurs after admission – d. When it occurs after admission
When the type of diabetes mellitus is not documented in the medical note, what is used
as the default type
a. Type 2
b. Type 1
c. Can be type 1 or 2
d. Scondary diabetes – a. Type 2
When is it appropriate to use history of malignancy, from category Z85
a. once the malignancy is removed form that site but the patient is still receiving
chemotherapy
b. When the patient cancels treatment for that site<\/p>\n\n\n\n

c. It has been excised, no evidence of any existing primary malignancy, and there is not
further treatment directed to the site
d. when 5 years has passed after surgery – c. It has been excised, no evidence of any
existing primary malignancy, and there is not further treatment directed to the site
If a patient uses insulin, what type of diabetic does it mean the patient is
a. secondary diabetes
b. type 2
c. type 1
d. the use of insulin does not specify the patient is a certain type of diabetic – d. the use
of insulin does not specify the patient is a certain type of diabetic
Pneumonia due to adenovirus. What ICD-1-CM code is reported
a. B34.0
b. J12.0
c. B97.0
d. B30.1 – b. J12.0
a 50 year old patient has been diagnosed with elevated blood pressure. The patient
does not have a history of hypertension. The correct ICD-10-CM code to report is
a. R03.0
b. I10
c. I13.0
d. I15.0 – b. I10
What type of fracture is considered traumatic
a. pathologic fracture
b. spontaneous fracture
c. stress fracture
d. compound fracture – d. compound frature
Can Z codes be listed as a primary code?
a. No; Z codes are never listed as primary codes
b. No; Z codes are always reported as secondary codes
c. No; Z codes are reported for external injuries and where it happened which is always
listed as secondary
d. Yes; Z codes can be sequenced as primary and secondary codes – d. Yes; Z codes
can be sequenced as primary and secondary codes
Where can you find the Table of Drugs and Chemicals<\/p>\n\n\n\n

CPC 2021 Exam Study Guide
Documentation (content) – Proper code assignment is determined both by
_<\/em><\/strong><\/em><\/strong> in the medical record and by the unique rules that govern each code
set in that instance
An auditor – The role a coder may take on to verify that the documentation supports the
codes the physician has selected
Query the physician – If the medical record is inaccurate or incomplete, it will not
translate properly to the language of codes. What can a coder do in order for the
medical record to be complete and accurate so they can bill properly?
Quarterly (usually) – How often are codes and insurance payment policies updated?
NPP – Non-Physician Provider (also known as mid-level providers or physician
extenders)
PA – Physician assistant
NP – Nurse practitioner
Commercial and Government – The two types of primary insurances
Commercial Carriers – Private payers that may offer both group and individual plans
Medicare – The most significant government insurer; a federal health insurance program
People over 65, blind or disabled individuals, and people with permanent kidney failure
or end-stage renal disease – Medicare provides coverage for what kind of people?
ESRD – end-stage renal disease
Medicare Part A – Helps cover inpatient hospital care, as well as care provided in skilled
nursing facilities, hospice care, and home healthcare,
Medicare Part B – Covers medically necessary physicians’ services, outpatient care, and
other medical services (including some preventive services) not covered under
Medicare Part A. It can be an optional benefit.
Medicare Part C – Also called Medicare Advantage, combines the benefits of Medicare
Part A, Part B, and-sometimes- Part D. The plans are managed by private insurers
approved by Medicare.
Medicare Part D – A prescription drug program available to all Medicare beneficiaries.<\/p>\n\n\n\n

Medicaid – A health insurance assistance program for some low-income people
(especially children and pregnant women) sponsored by federal and state governments.
RBRVS – Resource-Based Relative Value Scale
Resource-Based Relative Value Scale (RBRVS) – Medicare payments for physician
services are standardized using _<\/strong> and are divided into three components.
The physician work component, practice expense, and professional liability insurance
(PLI) – The three components used to determine resource cost for physician services.
The Physician Work component – Accounts for just over half (52 percent) of a
procedure’s\/service’s total relative value and is measured by time it takes to perform a
service, technical skill, and physical effort.
Practice Expense – Accounts for 44 percent of the total relative value for each service
and differ by site of service. For example, the expense of providing services in the
hospital vs a physician’s office.
PLI – Resource-Based Professional Liability Insurance
Professional Liability Insurance (PLI) – Accounts for 4 percent of the total relative value
for each service
CMS website – Where can you find Physician Fee Schedule (PFS) information?
PFS – Physician Fee Schedule
Medical Necessity – Refers to whether a procedure or service is considered appropriate
in a given circumstance
NCD – National Coverage Determinations
National Coverage Determinations (NCD) – Explains when Medicare will pay for items or
services
MAC – Medicare Administrative Contractor
Medicare Administrative Contractor (MAC) – Responsible for interpreting national
policies into reginal polices.
Local Coverage Determinations (LCD) – Regional policies converted from national
polices by a Medicare Administrative Contractor (MAC).
ABN – Advance Beneficiary Notice<\/p>\n\n\n\n

AAPC CPC Testbank Exam Prep 2022.
A 46-year-old female had a previous biopsy that indicated positive malignant margins
anteriorly on the right side of her neck. A 0.5 cm margin was drawn out and a 15 blade
scalpel was used for full excision of an 8 cm lesion. Layered closure was performed
after the removal. The specimen was sent for permanent histopathologic examination.
What are the CPT\u00ae code(s) for this procedure?
A. 11626
B. 11626, 12004-51
C. 11626, 12044-51
D. 11626, 13132-51, 13133 – C. 11626, 12044-51
A 30-year-old female is having 15 sq cm debridement performed on an infected ulcer
with eschar on the right foot. Using sharp dissection, the ulcer was debrided all the way
to down to the bone of the foot. The bone had to be minimally trimmed because of a
sharp point at the end of the metatarsal. After debriding the area, there was minimal
bleeding because of very poor circulation of the foot. It seems that the toes next to the
ulcer may have some involvement and cultures were taken. The area was dressed with
sterile saline and dressings and then wrapped. What CPT\u00ae code should be reported?
A. 11043
B. 11012
C. 11044
D. 11042 – C. 11044
A 64-year-old female who has multiple sclerosis fell from her walker and landed on a
glass table. She lacerated her forehead, cheek and chin and the total length of these
lacerations was 6 cm. Her right arm and left leg had deep cuts measuring 5 cm on each
extremity. Her right hand and right foot had a total of 3 cm lacerations. The ED
physician repaired the lacerations as follows: The forehead, cheek, and chin had
debridement and cleaning of glass debris with the lacerations being closed with one
layer closure, 6-0 Prolene sutures. The arm and leg were repaired by layered closure,
6-0 Vicryl subcutaneous sutures and Prolene sutures on the skin. The hand and foot
were closed with adhesive strips. Select the appropriate procedure codes for this visit.
A. 99283-25, 12014, 12034-59, 12002-59, 11042-51
B. 99283-25, 12053, 12034-59, 12002-59
C. 99283-25, 12014, 12034-59, 11042-51
D. 99283-25, 12053, 12034-59 – D. 99283-25, 12053, 12034-59
A 52-year-old female has a mass growing on her right flank for several years. It has
finally gotten significantly larger and is beginning to bother her. She is brought to the
Operating Room for definitive excision. An incision was made directly overlying the
mass. The mass was down into the subcutaneous tissue and the surgeon encountered
a well encapsulated lipoma approximately 4 centimeters. This was excised primarily
bluntly with a few attachments divided with electrocautery. What CPT\u00ae and ICD-10-CM
codes are reported?<\/p>\n\n\n\n

A. 21932, D17.39
B. 21935, D17.1
C. 21931, D17.1
D. 21925, D17.9 – C. 21931, D17.1
Question 5
PREOPERATIVE DIAGNOSIS: Right scaphoid fracture. TYPE OF PROCEDURE: Open
reduction and internal fixation of right scaphoid fracture. DESCRIPTION OF
PROCEDURE: The patient was brought to the operating room; anesthesia having been
administered. The right upper extremity was prepped and draped in a sterile manner.
The limb was elevated, exsanguinated, and a pneumatic arm tourniquet was elevated.
An incision was made over the dorsal radial aspect of the right wrist. Skin flaps were
elevated. Cutaneous nerve branches were identified and very gently retracted. The
interval between the second and third dorsal compartment tendons was identified and
entered. The respective tendons were retracted. A dorsal capsulotomy incision was
made, and the fracture was visualized. There did not appear to be any type of
significant defect at the fracture site. A 0.045 Kirschner wire was then used as a
guidewire, extending from the proximal pole of the scaphoid distal ward. The guidewire
was positioned appropriately and then measured. A 25-mm Acutrak\u00ae drill bit was drilled
to 25 mm. A 22.5-mm screw was selected and inserted and rigid internal fixation was
accomplished in this fashion. This was visualized under the OEC imaging device in
multiple projections. The wound was irrigated and closed in layers. Sterile dressings
were then applied. The patient tolerated the procedure well and left the operating room
in stable condition. What CPT\u00ae code is reported for this procedure?
A. 25628-RT
B. 25624-RT
C. 25645-RT
D. 25651-RT – A. 25628-RT
An infant with genu valgum is brought to the operating room to have a bilateral medial
distal femur hemiepiphysiodesis done. On each knee, the C-arm was used to localize
the growth plate. With the growth plate localized, an incision was made medially on both
sides. This was taken down to the fascia, which was opened. The periosteum was not
opened. The Orthofix\u00ae figure-of-eight plate was placed and checked with X-ray. We
then irrigated and closed the medial fascia with 0 Vicryl suture. The skin was closed
with 2-0 Vicryl and 3-0 Monocryl\u00ae. What procedure code is reported?
A. 27470-50
B. 27475-50
C. 27477-50
D. 27485-50 – D. 27485-50
The patient is a 67-year-old gentleman with metastatic colon cancer recently operated
on for a brain metastasis, now for placement of an Infuse-A-Port for continued
chemotherapy. The left subclavian vein was located with a needle and a guide wire
placed. This was confirmed to be in the proper position fluoroscopically. A transverse
incision was made just inferior to this and a subcutaneous pocket created just inferior to<\/p>\n\n\n\n

this. After tunneling, the introducer was placed over the guide wire and the power port
line was placed with the introducer and the introducer was peeled away. The tip was
placed in the appropriate position under fluoroscopic guidance and the catheter trimmed
to the appropriate length and secured to the power port device. The locking mechanism
was fully engaged. The port was placed in the subcutaneous pocket and everything sat
very nicely fluoroscopically. It was secured to the underlying soft tissue with 2-0 silk
stitch. What CPT\u00ae code(s) is (are) reported for this procedure?
A. 36556, 77001-26
B. 36558
C. 36561, 77001-26
D. 36571 – C. 36561, 77001-26
Question 8
A CT scan identified moderate-sized right pleural effusion in a 50 year-old male. This
was estimated to be 800 cc in size and had an appearance of fluid on the CT Scan. A
needle is used to puncture through the chest tissues and enter the pleural cavity to
insert a guidewire under ultrasound guidance. A pigtail catheter is then inserted at the
length of the guidewire and secured by stitches. The catheter will remain in the chest
and is connected to drainage system to drain the accumulated fluid. The CPT\u00ae code is:
A. 32557
B. 32555
C. 32556
D. 32550 – A. 32557
The patient is a 59-year-old white male who underwent carotid endarterectomy for
symptomatic left carotid stenosis a year ago. A carotid CT angiogram showed a
recurrent 90% left internal carotid artery stenosis extending into the common carotid
artery. He is taken to the operating room for re-do left carotid endarterectomy. The left
neck was prepped and the previous incision was carefully reopened. Using sharp
dissection, the common carotid artery and its branches were dissected free. The patient
was systematically heparinized and after a few minutes, clamps were applied to the
common carotid artery and its branches. A longitudinal arteriotomy was carried out with
findings of extensive layering of intimal hyperplasia with no evidence of recurrent
atherosclerosis. A silastic balloon-tip shunt was inserted first proximally and then
distally, with restoration of flow. Several layers of intima were removed and the
endarterectomized surfaces irrigated with heparinized saline. An oval Dacron patch was
then sewn into place with running 6-0 Prolene. Which CPT\u00ae code(s) is\/are reported?
A. 35301
B. 35301, 35390
C. 35302
D. 35311, 35390 – B. 35301, 35390
A 52-year-old patient is admitted to the hospital for chronic cholecystitis for which a
laparoscopic cholecystectomy will be performed. A transverse infraumbilical incision
was made sharply dissecting to the subcutaneous tissue down to the fascia using
access under direct vision with a Vesi-Port and a scope was placed into the abdomen.<\/p>\n\n\n\n

Three other ports were inserted under direct vision. The fundus of the gallbladder was
grasped through the lateral port, where multiple adhesions to the gallbladder were taken
down sharply and bluntly: The gallbladder appeared chronically inflamed. Dissection
was carried out to the right of this identifying a small cystic duct and artery, was clipped
twice proximally, once distally and transected. The gallbladder was then taken down
from the bed using electrocautery, delivering it into an endo-bag and removing it from
the abdominal cavity with the umbilical port. What CPT\u00ae and ICD-10-CM codes are
reported?
A. 47564, K81.2
B. 47562, K81.1
C. 47610, K81.2
D. 47600, K81.1 – B. 47562, K81.1
A 70-year-old female who has a history of symptomatic ventral hernia was advised to
undergo laparoscopic evaluation and repair. An incision was made in the epigastrium
and dissection was carried down through the subcutaneous tissue. Two 5-mm trocars
were placed, one in the left upper quadrant and one in the left lower quadrant and the
laparoscope was inserted. Dissection was carried down to the area of the hernia where
a small defect was clearly visualized. There was some omentum, which was adhered to
the hernia and this was delivered back into the peritoneal cavity. The mesh was tacked
on to cover the defect. What procedure code(s) is (are) reported?
A. 49560, 49568
B. 49652
C. 49653
D. 49652, 49568 – B. 49652
The patient is a 50-year-old gentleman who presented to the emergency room with
signs and symptoms of acute appendicitis with possible rupture. He has been brought to
the operating room. An infraumbilical incision was made which a 5-mm VersaStep\u2122
trocar was inserted. A 5-mm 0- degree laparoscope was introduced. A second 5-mm
trocar was placed suprapubically and a 12-mm trocar in the left lower quadrant. A
window was made in the mesoappendix using blunt dissection with no rupture noted.
The base of the appendix was then divided and placed into an Endo-catch bag and the
12-mm defect was brought out. Select the appropriate code for this procedure:
A. 44970
B. 44950
C. 44960
D. 44979 – A. 44970
A 45-year-old male is going to donate his kidney to his son. Operating ports where
placed in standard position and the scope was inserted. Dissection of the renal artery
and vein was performed isolating the kidney. The kidney was suspended only by the
renal artery and vein as well as the ureter. A stapler was used to divide the vein just
above the aorta and three clips across the ureter, extracting the kidney. This was placed
on ice and sent to the recipient room. The correct CPT\u00ae code is:
A. 50543<\/p>\n\n\n\n

AAPC CPC exam Compliance and Regulatory
What document is referenced to when looking for potentialproblem areas identified by the
government indicatingscrutiny of the services within the coming year?:
A) OIG Compliance Plan Guidance
B) OIG Security Summary
C) OIG Work Plan
D) OIG Investigation Plan – C (Rationale: Twice a year, the OIG releases a Work Plan outlining
its priorities for the fiscal year ahead. Within the Work Plan, potential problem areas with claims
submissions are listed and will be targeted with special scrutiny.)
What form is provided to a patient to indicate a servicemay not be covered by Medicare and the
patient may be responsible for the charges?:
A) LCD
B) CMS-1500
C) UB-04
D) ABN – D (Rationale: An Advanced Beneficiary Notice (ABN) is used when a Medicare
beneficiary requests or agrees to receive a procedure or service that Medicare may not cover.
This form notifies the patient of potential out of pocket costs for the patient.)
Under HIPAA, what would be a policy requirement for “minimum necessary”? “
A) Only individuals whose job requires it may have access to protected health information.
B) Only the patient has access to his or her own protected health information.
C) Only the treating provider has access to protected health information.
D) Anyone within the provider’s office can have access to protected health information. – A
(Rationale: It is the responsibility of a covered entity to develop and implement policies, best
suited to its particular circumstances to meet HIPAA requirements. As a policy requirement,
only those individuals whose job requires it may have access to protected health information.)
Which statement describes a medically necessary service? :
A) Performing a procedure\/service based on cost to eliminate wasteful services.
B) Using the least radical service\/procedure that allows for effective treatment of the patient’s
complaint or condition.
C) Using the closest facility to perform a service or procedure.
D) Using the appropriate course of treatment to fit within the patient’s lifestyle. – B (Rationale:
Medical necessity is using the least radical services\/procedure that allows for effective treatment
of the patient’s complaint or condition.)
According to the example LCD from Novitas Solutions, which of the following conditions is
considered a systemic condition that may result in the need for routine foot care? :
A) arthritis
B) chronic venous insufficiency<\/p>\n\n\n\n

C) hypertension
D) muscle weakness – B (Rationale: According to the LCD, Chronic venous insufficiency is a
systemic condition that may result in the need for routine foot care.)
When presenting a cost estimate on an ABN for a potentially noncovered service, the cost
estimate should be within what range of the actual cost?
A) $25 or 10 percent
B) $100 or 10 percent
C) $100 or 25 percent
D) An exact amount – C (Rationale: CMS instructions stipulate, “Notifiers must make a good
faith effort to insert a reasonable estimate\u2026the estimate should be within $100 or 25 percent of
the actual costs, whichever is greater.”)
Which act was enacted as part of the American Recovery and Reinvestment Act of 2009
(ARRA) and affected privacy and security? :
A) HIPAA
B) HITECH
C) SSA
D) PPACA – B
What document assists provider offices with the development of Compliance Manuals?
A) OIG Compliance Plan Guidance
B) OIG Work Plan
C) OIG Suggested Rules and Regulations
D) OIG Internal Compliance Plan – A (Rationale: The OIG has offered compliance program
guidance to form the basis of a voluntary compliance program for physician offices. Although
this was released in October 2000, it is still considered as active compliance guidance today.)
Select the TRUE statement regarding ABNs.
A) ABNs may not be recognized by non-Medicare payers.
B) ABNs must be signed for emergency or urgent care.
C) ABNs are not required to include an estimate cost for the service.
D) ABNs should be routinely signed by Medicare Beneficiaries in case Medicare doesn’t cover a
service. – A (Rationale: ABNs may not be recognized by non-Medicare payers. Providers should
review their contracts to determine which payers will accept an ABN for services not covered.)
Who would NOT be considered a covered entity under HIPAA?
A) Doctors
C) HMOs
D) Clearinghouses
E) Patients – E (Rationale: Covered entities in relation to HIPAA include Health Care Providers,
Health Plans, and Health Care Clearinghouses. The patient is not considered a covered entity
although it is the patient’s data that is protected.)<\/p>\n","protected":false},"excerpt":{"rendered":"

CPC Exam – 150 Questions and Answers Complete 2022 solution guide. (answered) CPC Exam Study Guidelines to Ace Your CPC Certification Exam. CPC Exam Study Guide 2021\/2022: Questions and Answers. AAPC CPC Testbank Exam Prep 2022 Complete Questions & Answers. (answered) AAPC CPC exam Compliance and Regulatory 2022. CPC Practice Exam – 150 QuestionsSurgical removal […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-120186","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/120186","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=120186"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/120186\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=120186"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=120186"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=120186"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}